INDIANAPOLIS—Josh Phegleyof Triple-A Charlotte has played baseball since age 5, so the White Sox prospect knows all about RBIs. But until it nearly derailed his career, he'd never heard of ITP—idiopathic thrombocytopenic purpura.

It's axiomatic that catchers are tougher than two-dollar steaks. "It comes along with the position," said Charlotte manager Joel Skinner, who caught for nine big league seasons. But even for a catcher, this was a tough hill to climb.

The 5-foot-10, 215-pound Phegley built a reputation for toughness from his prep days. As a senior at Terre Haute North High in 2006, Phegley hit .592 with 13 homers and 50 RBIs to win Indiana's Mr. Baseball honors. The day before a high school all-star series opened, he got food poisoning.

"I was vomiting all night long," Phegley remembered. "The next day my stomach was so sore I could hardly stand. But I played and ended up hitting a home run in my first at-bat."

As a freshman at Indiana that fall, Phegley won the starting catcher's job. In the summer of 2007 he was playing in the Cape Cod League when he broke a bone in his hand.

"I was scheduled to fly home," he said, "but the day before the flight, I had appendicitis. So I had to stay there and have surgery."

Back in Bloomington that fall, Phegley was doing conditioning drills when misfortune struck again. "We were running around the indoor facility," he said, "and I ran into someone. It jammed my shoulder and frayed my labrum." He had shoulder surgery on Dec. 4. "I started our first game on Feb. 22, 2008," he said, "so it was a quick turnaround."

Phegley started all of Indiana's 61 games. He batted .438 with 15 homers and 80 RBIs and was a unanimous pick for all-Big Ten Conference honors. He was all-Big Ten again in 2009 with a .344 average, 17 home runs and 66 RBIs. That June, the White Sox made him a supplemental first-round pick (38th overall).
Life Changer

After breaking in with low Class A Kannapolis in 2009, Phegley was assigned to high Class A Winston-Salem for 2010. The problems began during spring training. "From carrying my catcher's bag over my shoulder, I'd have a stripe of red dots," he said. "Then I started seeing them on my back."

Just after the start of the regular season, Phegley took a foul ball off his thigh. "As a catcher, that's a daily thing," he said. But this time the bruise was the size of a basketball, and the discoloration continued to grow. "It was like a fresh bruise every day," he said.

The morning after the sixth game of the year, Josh visited a Winston-Salem clinic. "They ran my bloodwork," he said, "and before I got home they called. They said, 'You need to get yourself to the hospital right now.' "

The diagnosis was ITP, a platelet disorder resulting in blood clotting issues. "Thrombocytopenia deals with the platelets," Phegley said. "Purpura is the red dots you see from it. Idiopathic means there's no known cause for it."

Those red dots were the result of ruptured capillaries due to thin blood. "My platelet count was dangerously low," he said. "The normal blood platelet count is between 150,000 and 350,000. I had the lowest reading you could have, without it being zero."

After so many things had not been able to keep Phegley down, suddenly he was confined to a hospital bed.

"They told me, 'Even brushing your teeth, your gums could start to bleed,' " he said. "You feel like you're in top physical condition, and you hear that you could be dying . . . It was kind of scary."

The first stage of treatment involved taking medicine that boosted Phegley's platelet production. The next step was weekly intravenous treatments that lasted six hours. "Then they started giving me shots, which boosted my platelets really high," he said.

Back To Action

Phegley returned to action after six weeks. He got into 48 games for Rookie-level Bristol, Winston-Salem and Double-A Birmingham. He was scheduled to play in the Arizona Fall League, but the red dots returned.

The injections Phegley had been taking involved risks. "They didn't know the long-term effects," he said. "They'd used them on cancer patients and older people, but not on anyone young. It got to the point where I didn't want to keep taking them if there was another option."

That option was removing Phegley's spleen, a non-vital organ that acts primarily as a blood filter, because doctors believed that's where the platelets were being destroyed.

"It was a joint decision," Phegley said. "I thought if I wanted to be ready for next season, I need to get home, have the operation, and have plenty of time to recover."

The surgery took place on Nov. 5, 2010, in Chicago. "Within two weeks, I was doing baseball stuff," Phegley said.

Healthy for Opening Day 2011, he got into 94 games for Birmingham and 22 more for Charlotte. "They said I improved greatly defensively," Phegley said. "But to make it through the whole year after what I'd been through was a personal victory."

Phegley still has plenty to work on. He has a strong arm but isn't particularly quick behind the plate. He has to show he can catch up to good fastballs, which explains his .256/.294/.338 line this year. But he's healthy and moving in the right direction again. He made the International League squad for the Triple-A all-star game, and Skinner believes he has a major league future.

"He's a gritty kid," Skinner said. "He's strong, he's quick, he has a strong throwing arm. It's just a matter of him continuing to corral everything, and get himself to where it all comes together at the major league level."